Provider Demographics
NPI:1063074177
Name:DALY, NIKKI BLAKE (MS, CCC-SLP, TSSLD)
Entity type:Individual
Prefix:
First Name:NIKKI
Middle Name:BLAKE
Last Name:DALY
Suffix:
Gender:F
Credentials:MS, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 E 82ND ST APT 6H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-5937
Mailing Address - Country:US
Mailing Address - Phone:516-316-6679
Mailing Address - Fax:
Practice Address - Street 1:2750 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-2210
Practice Address - Country:US
Practice Address - Phone:516-316-6679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-28
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027912235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist